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St Thomas General Surgery
Academic Aspects Preceptors General surgery group of 4 surgeons - Dr. Black is rotation director - very approachable, friendly group, positive towards family medicine residents. Overall excellent teachers. ..... Teaching to Service ratio Very good. Family Medicine residents generally are in charge of the high volume daily clinics. Lots of opportunities to see new consults and also perform small procedures (ex. Lumps and bumps, injections, anoscopy). Limited time spent in the operating room, which is generally to the benefit of family medicine residents. Dr. Collins is also enthustiastic about teaching. Dr. McLachlin is somewhat more gruff/old school but does some teaching. Other Learners Usually 2 family medicine residents + 1-2 general surgery residents per month. Gen surg resident serves as the senior resident, ensuring adequate coverage of inpatient, operating room and clinic responsibilities. Location Practice Population Varied population from around St. Thomas and London. Community St. Thomas is a smaller south-western Ontario community, nearby Ford plant with many local workers; close to shore of Lake Erie. Accommodations None available, but very easy commute from London (~35 minutes from downtown London, 50 minutes in snowy weather) Week in the Life of... What does a typical work week look like on this rotation? Start of day usually ~7:00 depending on number of inpatients. Resident team rounds together on inpatients. Following this, general surgery residents go to OR and family medicine residents to clinic. If clinic is starting earlier (ex. 7:30) and inpatient rounds are not yet complete, clinic takes priority and family medicine residents are to present there. Clinics run daily, usually morning and afternoon; all on-site at St. Thomas hospital. When clinic is complete, family medicine residents have option to join operating room team or observe at colonoscopy suite. Call requirements Home call, divided between residents. For on-call resident, during the day they may be asked to see consults in the emergency department or on off-service inpaitnets. At end of day, if there are emergency surgical cases on the board, on-call resident remains to assist. When OR and inpatient issues are completed (often by 7:00pm) resident can return home. Overnight, calls about inpatient issues can usually be fielded over the phone from the nursing staff. Infrequently, will need to return to hospital to see a consult or for an emergency surgery requiring surgical assist. Weekend call is usually quiet and you may be out of there by around noon. If Dr. McLachlin is on call he tends to book a lot of elective cases so it is more like a regular work day. Other Things to add A really great rotation - highly recommended! Friendly team, lots of hands-on learning in the clinic, and less learning hierarchy than in London. Date of Last Edit: October 2013 -Reasonable workload; you need to find a family medicine focus. I found the OR fairly useless as the staff (who are all great) focus on teaching the gen surg resident (usually they're R2 or so, so they haven't done a lot of operating yet). Clinics were the best learning experience and great for lumps and bumps. Generally once you were able to demonstrate that you could remove a cyst/etc.. they would let you do it basically solo. Dr. Black micromanages a little in the clinic but the others let you guide yourself. McLachlin's clinic days are BUSY (80ish patients a day) Great rotation. Everyone is approachable. Dr. Bottoni is a new surgeon there, but he is great. Dr. Ana Igric is covering some weekends and does good teaching. All of the doctors here are great and the work load is reasonable. I think is the best surgery rotation for FM residents as we get to do clinics and consults as well as small procedures. - when I was on my gen surg rotation, there were 2 FM R1s and we did not have any surgery residents. This meant that we had to alternated being in the OR as they needed someone to retract/assist. I personally am not interested in spending time in the ORs and found that to provide minimal learning. the clinics and seeing consults in emerg was much more valuable. In terms of call, since it is home call, I never got called to come in to assist in the OR even when the staff did come in to operate. This is a great rotation for Gen Surg for family medicine. Lots of experience with lumps and bumps type of experience.